What is REBOA (Resuscitative Endovascular Balloon Occlusion of the Aorta)

 

A minimally invasive technique using a balloon catheter to temporarily occlude large vessels in support of hemorrhage control.

 

Hemorrhage leads to cardiovascular collapse and death unless blood flow to the heart muscle and brain is maintained. For patients with truncal hemorrhage, resuscitative aortic occlusion helps maintain blood flow to these critical organs until the hemorrhage can be definitively controlled via surgery.

 

Until REBOA, resuscitative aortic occlusion required an invasive surgical procedure which resulted in high mortality and significant resource usage.

 

ANATOMY

 

The aorta is divided into three separate zones for the purposes of REBOA (aortic length varies between individuals)

Balloon Landing Zones

 

    Aortic Zone 1

 

•  Extends from the origin of the left subclavian artery to the celiac artery ( approximate vessel diameter -20mm –young adult male)

 

    Aortic Zone 3

 

•  Extends from the lowest renal artery to the aortic bifurcation ( approximate vessel diameter -15mm –young adult male)

 

1- Stannard A, Morrison JJ, Sharon DJ, Eliason JL, RasmussenTE, Morphometric analysis of torso arterial anatomy with implications for resuscitative aortic occlusion. J Trauma Acute Care Surg. 2013; Vol 75:S169-S172

 

2- Teeter WA, Matsumoto J, Idoguchi K, Kon Y, Orita T, Funabiki T, Brenner ML, Matsumura Y. Smaller introducer sheaths for REBOA may be associated with fewer complications. J Trauma Acute Care Surg. 2016; Vol81, Number 6